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Diabetes Diet

Two Large Meals a Day for Diabetes

Until now, some experts on health have recommended that we eat several small meals a day to help us lose weight. It also seemed logical that eating smaller meals would have less of an impact on the blood sugar of those of us with diabetes.

But a new study demonstrated that some people with type 2 diabetes who ate only breakfast and lunch lost more weight than when they ate six smaller meals a day. In this randomized crossover study they also had bigger decreases in fasting blood sugar, bigger improvement in insulin sensitivity, and bigger improvements in other markers of better diabetes management.

Researchers in the Czech Republic worked with 54 people with diabetes for 24 weeks to have them eat the same number of calories spread over either two or six meals a day. The people in the study followed diets of eating six small meals a day or two large daily meals for 12 weeks. Then they switched to the other diet plan for 12 more weeks.

In the two-meal group they ate breakfast between 6 a.m. and 10 a.m. followed by lunch between noon and 4 p.m. When they switched diet plans they could eat six times a day whenever they wanted.

Each diet had 500 fewer calories than normal. When they ate the two bigger meals, they averaged a weight loss of 3 pounds more and lost 1 1/2 inches more from their waist size than when they ate six smaller meals of equal total calories.

“Eating only breakfast and lunch reduced body weight, liver fat content, fasting plasma glucose, C-peptide and glucagon, and increased oral glucose insulin sensitivity more than the same caloric restriction split into six meals,” says Hana Kahleova, MD, PhD. She is the study’s lead author and a researcher at the Diabetes Centre of the Institute for Clinical and Experimental Medicine in Prague. The journal of the European Association for the Study of Diabetes, Diabetologia, published this research May 20 online in advance of print.

“The patients were really afraid they would get hungry in the evening,” says Dr. Kahleova. “But feelings of hunger were lower as the patients ate until they were satisfied. When they ate six times a day the meals were not leaving them feeling satisfied. It was quite surprising.”

Dr. Kahleova calls the two-meal diet “intermittent fasting.” Skipping dinner and therefore fasting for the 14 to 22 hours without food in this study might deserve that label. But last year when I recommended skipping dinner for weight loss I wrote that “Sometimes I tell myself that skipping dinner is intermittent fasting. But that would be an exaggeration.”

I recommended it then only for weight loss. In fact I skipped dinner last night because I ate too much the day before. I know that it works for weight loss, and the finding of this new study that shows it also works for reducing our blood sugar level is an unexpected bonus.

We may not even have to skip dinner entirely to get some of the weight loss and blood sugar control benefits that the people in this study achieved. A very small dinner might well offer some of the benefits that Dr. Kahleova found in her study.

“Our results support the ancient proverb: Eat breakfast like a king, lunch like a prince, and dinner like a pauper,” she says. Her study sure gives this old adage new life.

This article is based on an earlier version of my article published by HealthCentral.

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  • Claudia Langley at

    Will do … Love it fried, but now seldom do that. Was hoping I would like it fermented … But no …

  • David Mendosa at

    Dear Claudia,

    Actually, okra is one of my favorite veggies. I minimize the slime by NOT cutting off the ends or cutting the pieces otherwise. I steam them for about 6 minutes. Try some again?

    Namaste,

    David

  • Claudia Langley at

    I am still needing a few more lbs off, but find it easy to skip breakfast, as I have just retired. Much more flexible schedule. I do lots of fermentation and eat some daily. A few tablespoons is all you need. Mostly do kraut and pickles, but also do garlic, radishes, carrots, green beans, in fact the only thing I didnt like was okra. Toooo slimy. I like to start with a small batch and see how successful it is. Love having more time for real food. Gardens, farmers markets, searching for local fare. All time consuming, but worth the effort. Just an old hippie I guess … Originally from CA , like you. Also make cheese, bake sourdough, make yogurt. I do as much as I can for myself. Better and healthier in every way. Now, near Asheville, NC. No shortage of foodies here. I love this area.

  • Claudia Langley at

    i have been following you since you first moved to Boulder. I was in Co Springs at the time.

  • Diana at

    The several small meals advice has never worked for me. Sticking to three regular meals about six hours apart has had more favorable outcomes.

    Recently I heard a talk about the digestive process and the fact that it takes about six hours for the body to complete digestion and that adding snacks interrupts it. I have never been a snacker and wonder if this is the reason.

    Thanks for everything you do!

  • Claudia Langley at

    I have been intermittent fasting, eating from 12:00 pm to 8:00 pm for about a yr and lost 35 lbs. I am diabetic and that has also improved, along with blood pressure. The other thing I added was fermented veges. I have been on a whole food type diet for many years. I found found the fasting very easy … I do it about 5 out of 7 days.

    • David Mendosa at

      Dear Claudia,

      Good for you! And you are doing intermittent fasting even more than I do. However, my weight is where I want it to be (my BMI is about 19.7).

      Are you saying that you fast in the morning and eating in the afternoon and evening? My guess is that most people would do it the other way around, but if it works for you, great!

      I am particularly glad that you mention fermented vegetables. Kimchi is the one that I love the most!

      Namaste,

      David